Coronary artery bypass grafting is becoming increasingly sophisticated as the main method of surgical treatment for coronary artery disease. From the mid-1990s when radial artery material was widely used in the clinic, great hopes were placed on its application as a bridge vessel. In the past 20 years, the superiority of coronary artery bypass grafting without extracorporeal circulation and total arterialized bypass grafting has been confirmed. The radial artery has been used as the preferred arterial bridge vessel after the internal thoracic artery in total arterialized coronary artery bypass grafting, and its efficacy has been confirmed. However, the likelihood of atherosclerosis in the radial and ulnar arteries is also increased in patients with coronary artery disease, so we applied Allen’s test along with the modified Allen’s test, noninvasive oxygen saturation measurement and vascular Doppler ultrasonography to get a comprehensive and accurate picture of the radial and ulnar arteries and collateral circulation in the forearm. The internal diameter and blood flow velocity of the ulnar artery were significantly higher than those of the contralateral side before and after surgery in this group, and there was no significant difference in the terminal oxygen saturation before and after surgery, which indicated that the compensatory effect of the ulnar artery could meet the basic demand of blood and oxygen supply to the forearm on the operated side. In this study, three early patients developed abnormal skin sensation in the greater interfascicular area and thumb after radial artery resection, which was considered to be caused by unskilled intraoperative operation, electric knife heat injury or excessive pulling of the lateral cutaneous nerve and superficial branch of the radial nerve in the forearm, but all patients recovered within 2 weeks after surgery, and none of them developed abnormal skin sensation in the forearm on the operated side after later skilled operation. Postoperative spasm of the graft bridge is the main cause of perioperative death in patients with coronary artery bypass graft. Therefore, we strictly screened the cases before surgery, familiarized ourselves with the anatomy of the forearm, selected the correct anatomical level, adopted a no-touch technique, operated gently, and avoided violent traction of the vessels to reduce the intrusion of the radial artery vessels; at the same time, we used a protective fluid containing isoptin and applied calcium antagonists intraoperatively and early postoperatively, thus effectively preventing the occurrence of postoperative arterial bridge spasm. In conclusion, familiarity with the anatomy of the radial artery, perfect preoperative evaluation, intraoperative use of the no-contact technique, and timely application of isoptin-containing protective fluid and calcium antagonists have led to excellent clinical results in the use of the radial artery as a vascular bridge in coronary artery bypass grafting.